Collins, King steadfast in opposing new Senate health care bill

U.S. Sens. Susan Collins and Angus King both voiced opposition Thursday to the latest version of the Republican plan to repeal and replace the Affordable Care Act.

Republican leaders in the Senate unveiled a revised plan Thursday to repeal and replace the Affordable Care Act, but the changes they made to the bill didn't persuade U.S. Sen. Susan Collins, R-Maine, to sign on as a supporter.

As she did in late June when the earlier version of the "Better Care Reconciliation Act of 2017" was unveiled, Collins issued a tweet expressing her unwillingness to support even a procedural motion to take up the bill for debate, possibly as early as next week.

"Still deep cuts to Medicaid in Senate bill," Collins tweeted on Thursday. "Will vote no on MTP [motion to proceed]. Ready to work w/GOP & Dem colleagues to fix flaws in ACA."

"This bill is no more encouraging than the last, which is to say it's still terrible. It still includes drastic cuts to Medicaid that will hurt Maine seniors, children, and people with disabilities. It still shifts costs to the states. It still has inadequate funding for opioid treatment, and now, by presenting barebones plans, it's going to drive up the cost of insurance for older, sicker people and likely put health care out of reach for them. None of this is good for Maine.

"And when it comes to the process, to have a few people craft a bill in secret — one that will impact millions of people's lives and one sixth of the American economy, no less — and then talk about voting on it early next week is simply atrocious, and it's totally inconsistent with how the Senate was designed to make laws. The Senate needs to abandon this approach and, instead, work in a bipartisan manner to make meaningful improvements to the Affordable Care Act."

What’s changed

The New York Times reported that the revised GOP bill, like the earlier version, would roll back the expansion of Medicaid under the ASC and would still convert that federal health care program for people with limited income from an open-ended entitlement to a system of fixed payments to states.

Other features of the revised bill as reported by the New York Times and USA Today:

Revised bill provides $70 billion in additional funds that states could use to help reduce premiums and hold down out-of-pocket medical costs.

In a departure from the ACA's "essential health benefits" provision, the bill would allow insurers, "under certain conditions, to offer health plans that did not comply with standards in the ACA."

Insurance plans would be allowed to charge customers in their 60s five times or more higher premiums that what younger customers pay for the same coverage; under the ACA they were limited to no more than three times higher.

It allows people to use health savings accounts with favorable tax benefits to pay for their insurance premiums.

It keeps the ACA's rule that dependent children can stay on a parent's plan until age 26.

The bill effectively removes the ACA's requirement that most people buy insurance by eliminating the tax penalties for failing to do so. Instead, it establishes a different type of disincentive to encourage people to stay covered: Those who have a gap in their insurance coverage would have to wait six months before they can re-enroll.

For a separate New York Times analysis that comes with visual charts showing all the Republican senators and how they stand on the various changes that were included in the new bill (or failed to get in), go here.